The top 20 cities for bed bug infestations in the United States — based on Terminix service requests — are listed below:

Cleveland, Ohio

Cincinnati, Ohio

Detroit, Mich.

Las Vegas, Nev.

Denver, Colo.

Houston, Texas

Phoenix, Ariz.

Indianapolis, Ind.

Oklahoma City, Okla.

Philadelphia, Pa.

Baltimore, Md.

Pittsburgh, Pa.

Washington, D.C.

Tucson, Ariz.

San Francisco, Calif.

St. Louis, Mo.

Atlanta, Ga.

Tampa, Fla.

Memphis, Tenn.

San Diego, Calif.

Terminix says bed bug infestations have significantly increased since the late 1990s, and factors may include increased international travel and insecticide resistance.

“Bed bugs are notoriously difficult to eradicate, and they can travel to new locations very easily—hitching a ride on clothing, handbags, suitcases and taxis, which can create substantial infestations in no time,” said Paul Curtis, director, technical services at Terminix.

The list was created by compiling services data from more than 300 Terminix branches across the country. The rankings represent Metropolitan Statistical Areas with the highest number of actual services between Jan. 1 and June 30, 2017, the company says.

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